Clinical and Experimental Nephrology

, Volume 22, Issue 3, pp 647–652 | Cite as

Decrease in toe pinch force in male type 2 diabetic patients with diabetic nephropathy

  • Hiroaki Kataoka
  • Nobuyuki Miyatake
  • Naomi Kitayama
  • Satoshi Murao
  • Satoshi Tanaka
Original article



The purpose of this cross-sectional study was to investigate the toe pinch force (TPF) of type 2 diabetic patients with diabetic nephropathy by disease stage, and to clarify the factors affecting the TPF.


Seventy-four men with diabetic nephropathy (age: 62.7 ± 8.9 years, duration of diabetes: 14.2 ± 8.6 years) were enrolled. According to the staging of diabetic nephropathy, TPF and knee extension force (KEF) were compared among three groups: normoalbuminuria, microalbuminuria, and overt nephropathy. In addition, we investigated factors influencing TPF and KEF by performing multiple regression analysis.


Normoalbuminuria group, microalbuminuria group, and overt nephropathy group included 26, 25, and 23 patients, respectively. The TPF of the overt nephropathy group (3.15 ± 0.75 kg) was significantly lower than that of the normoalbuminuria (4.2 ± 0.7 kg, p < 0.001) and microalbuminuria groups (3.65 ± 0.81 kg, p = 0.022). The KEF of the overt nephropathy group (37.1 ± 8.3 kgf) was significantly lower than that of the normoalbuminuria group (44.8 ± 8.3 kgf, p = 0.010). Multiple regression analysis revealed that diabetic polyneuropathy (DPN) and diabetic nephropathy were determinant factors of the TPF; and age, body mass index, and diabetic nephropathy were determinant factors of the KEF.


We found in male patients with diabetic nephropathy, the TPF and KEF decreased with progression of diabetic nephropathy. Furthermore, our findings suggest diabetic nephropathy and DPN are critically involved in the reduction of TPF and KEF.


Type 2 diabetes mellitus Diabetic nephropathy Toe pinch force 


Compliance with ethical standards


This study was supported by a research grant from charitable trust MIU foundation memorial fund.

Conflict of interest

The authors have declared that no conflict of interest exists.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee at which the studies were conducted (IRB approval number: E73) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards


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Copyright information

© Japanese Society of Nephrology 2017

Authors and Affiliations

  1. 1.Rehabilitation CenterKKR Takamatsu HospitalTakamatsu-cityJapan
  2. 2.Department of Hygiene, Faculty of MedicineKagawa UniversityKagawaJapan
  3. 3.Department of Diabetes and EndocrinologyKKR Takamatsu HospitalKagawaJapan
  4. 4.Department of Physical Therapy, Faculty of Health and WelfarePrefectural University of HiroshimaHiroshimaJapan

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